Reconstruction of the middle hepatic vein in live donor liver transplantation: will it improve donor liver function?

Abstract

Right liver graft with the middle hepatic vein sometimes induces postoperative liver failure in donors due to insufficient functional remnant liver volume. Venous drainage of the graft is important for prevention of congestion and proper function of the graft. Therefore right hepatic veins and the tributaries of the middle hepatic vein need reconstruction. The unique technique of reconstructing the middle hepatic vein, the right hepatic vein and the short hepatic veins using allografts and artificial grafts are discussed. Patients who had right hepatic and middle hepatic vein reconstructions had good graft functions and less hepatic congestion. This technique will be useful for preserving liver function in right liver lobe donors in Sri Lanka where more than 31% of the general population has fatty liver disease.